Maintenance or Discontinuation of Antidepressants in Primary Care
If I feel well and want to come off fluoxetine, what taper schedule and follow-up would you recommend given the relapse rates in this trial?
Top of the evidence hierarchy, independently funded. how we score evidence
Among 478 primary-care patients who felt well enough to stop long-term antidepressants (including fluoxetine 20 mg), 56% of those randomised to stop relapsed within a year versus 39% of those who stayed on their medication.
Worth asking
If I feel well and want to come off fluoxetine, what taper schedule and follow-up would you recommend given the relapse rates in this trial?
What it is FDA approved for
Read off the label. Trial duration and approval year are shown only where they were recorded — never inferred.
- Major depressive disorder (acute and maintenance treatment)
- Obsessive-compulsive disorder
- Bulimia nervosa (moderate to severe; binge-eating and vomiting behaviors)
- Panic disorder, with or without agoraphobia
- Depressive episodes associated with bipolar I disorder (in combination with olanzapine)
- Treatment-resistant depression (in combination with olanzapine)
Source
Maintenance or Discontinuation of Antidepressants in Primary Care — Lewis G, et al. (2021)
Top-tier peer-reviewed journal
Read the source: https://doi.org/10.1056/NEJMoa2106356
DOI: 10.1056/NEJMoa2106356
How this was scored
- Study design
- Randomised controlled trial
- Funding
- Independently funded
- Published in
- Top-tier peer-reviewed journal
- Sample size
- 478
- Preregistered
- Yes
- Conflicts disclosed
- No
- Independent of proponent
- Yes
- Retracted
- No
Read the full scoring rubric, including what it can't tell you.
Published August 19, 2026.
Where we put this study in context
Questions
How strong is the evidence behind this?
Resolv rates this source "gold standard". Top of the evidence hierarchy, independently funded. It scores 87 out of 100 on our published rubric. The score is calculated from recorded facts about the source — study design, funding, publication venue, sample size, preregistration — not typed in by an editor.
What is the source for this?
Maintenance or Discontinuation of Antidepressants in Primary Care — Lewis G, et al. (2021). Published in: Top-tier peer-reviewed journal. DOI: 10.1056/NEJMoa2106356. The full source is linked on this page so you can read it yourself.
Who paid for this research, and does that matter?
Study design: Randomised controlled trial. Funding: Independently funded. The researchers were independent of whoever benefits from the result. Industry sponsorship is one of the most reliably measured biases in medicine, which is why funding carries real weight in the score rather than sitting in a footnote.
Is fluoxetine (Prozac, Sarafem), prozac, sarafem FDA approved?
Yes — FDA approved for Major depressive disorder (acute and maintenance treatment), Obsessive-compulsive disorder, Bulimia nervosa (moderate to severe; binge-eating and vomiting behaviors), Panic disorder, with or without agoraphobia, Depressive episodes associated with bipolar I disorder (in combination with olanzapine), Treatment-resistant depression (in combination with olanzapine). Approval is for a specific indication, not for everything the drug is prescribed for.
Is this medical advice?
This is information to bring to your prescriber, not medical advice and not a reason to change anything on your own. Nothing here is an instruction to stop or reduce a medication. If you are in crisis, call or text 988.
This is information to bring to your prescriber, not medical advice and not a reason to change anything on your own. Nothing here is an instruction to stop or reduce a medication. If you are in crisis, call or text 988.